The BMJ Today: Marking International Workers’ Day

May 6, 2014

Across the world, celebrations marking the International Workers’ Day herald the onset of May. Having its origins in the ‘eight hour day’ movement, which signifies “eight hours labour, eight hours recreation, eight hours rest,” this day recognises efforts to transform labour policies towards promoting the welfare of workers.

Propitiously timed, we have a couple of blogs calling out to policy makers to pay heed to the work pressures faced by general practitioners (GPs) in the UK.

At times heartrending, at times amusing, but always real, Jonathon Tomlinson’s depiction of a typical working day of a GP makes one sympathize with the demanding nature of the job. Balancing the pressures of a schedule packed with back to back appointments, a computer that flashes alerts to follow ALL evidence based recommendations for each patient, while being accountable for the costs and quality of care make for a tough ask. Alas, building a rapport with your patient takes a back seat, laments Tomlinson, as he identifies how “nobody in policy—such as those behind last week’s report into the future of Primary Care—seems to understand what it is we GPs do all day. The gap between their proposals for more technology and our need for more time and human interaction seem to be getting wider than ever.”

A real threat, writes Kate Barnes, a general practitioner, in a rapid response to another article, is that patients may gravitate towards questionable therapies offered under the label of complementary medicine, in the absence of a therapeutic relationship having been established with their GP.

Concurring with the pressures faced by GPs in coping with their daily workload, Azeem Majeed, a professor of primary care, proposes an alternative employment model. In what he describes as a win win solution for GPs and the NHS, Majeed believes that “to ensure general practice remains an attractive career option, and that primary care remains the foundation of the NHS, we need to consider the introduction of a salaried GP service in which GPs are employed by the NHS.”

Karl Marx, the torchbearer of workers’ rights, recognised long ago the impact of unfavorable working conditions on health and quality of life, suggesting it “not only produces a deterioration of human labour power by robbing it of its normal moral and physical conditions of development and activity, but also produces the premature exhaustion and death of this labour power itself.” As comes forth in Tomlinson’s blog, the anxiety that doctors may face at any moment during a consultation derides the very merits of being in this profession.

It is time policy makers tune into the voices of doctors practising at the front line to ensure that the care delivered and those delivering it doesn’t suffer.

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